Risk Levels and Enrollment Verification Requirements
Minnesota Health Care Programs (MHCP) determines risk level for any items indicated with an asterisk (*). The Centers for Medicare & Medicaid Services determines all other risk levels. Refer to MHCP acronyms for acronym key.
Provider Types | Risk Level | Requires Site Visits | Requires Enrollment Fee |
00 Nursing Facility | High for new enrollees; Moderate for existing providers at revalidation | X | X |
01 Hospital | Limited | X | |
02 Hospice | High for new enrollees; | X | X |
03 Institution for Mental Disease | Limited | X | |
04 Renal Dialysis Center | Limited | X | |
05 ICF-DD – Intermediate Care Facility – Developmental Disability | Limited | X | |
06 Children's Residential Treatment | Limited | X | |
08 Nursing Home Entity - Administrative Only | Limited | ||
09 School District IEP – Individualized Education Programs Service | Limited; | If providing CTSS | X |
10 Community Mental Health Center | Moderate | X | X |
11 Rehabilitation Agency | Limited; | If CORF certified | If CORF |
14 Licensed Individual Clinical Social Worker | Limited | ||
15 Licensed Dietician or Licensed Nutritionist | Limited | ||
16 Child and Teen Checkups Clinic | Limited | ||
17 Regional Treatment Center | Limited | ||
18 Home and Community Based Services | Limited | X – Excludes those without a Federal Employer ID Number (FEIN) | |
18 Housing Stabilization Services –(Program ended Oct. 31, 2025) | High* - Effective June 1, 2025. Submissions before June 1, 2025, are Limited risk. | X | X |
19 Day Training & Habilitation | Limited | X | |
20 Physician Clinic | Limited; | If CTSS or ARMHS | If CTSS or ARMHS |
20 Physician | Limited | ||
22 Ambulatory Surgical Center | Limited | X | |
23 County Case Manager - Administrative Only | Limited | ||
24 Managed Care Organization - Administrative Only | Limited | ||
25 Licensed Marriage and Family Therapist | Limited | ||
26 Certified Mental Health Rehab Professional | Limited | ||
27 Health Care Case Coordinator - Administrative Only | Limited | ||
28 EDI Trading Partner - Administrative Only | Limited | ||
29 Occupational Therapist | Limited | ||
30 Dental Clinic | Limited | ||
30 Dentist | Limited | ||
31 Dental Hygienist | Limited | ||
31 Dental Hygiene Group | Limited | ||
32 IDTF - Independent Diagnostic Testing Facility | Moderate | X | X |
33 Consolidated Provider Record - Administrative Only | Limited | ||
34 Mental Health Billing Entity | Limited; | If CTSS or ARMHS | If CTSS or ARMHS |
35 Optometrist | Limited | ||
36 Podiatry Group | Limited | ||
36 Podiatrist | Limited | ||
37 Chiropractors | Limited | ||
37 Chiropractic Group | Limited | ||
38 CFSS – Community First Services and Supports | High* | X | X |
38 PCPO – Personal Care Provider Organization | High* | X | X |
38 PCA/Consumer Directed Community Supports (CDCS)/Community First Services and Supports (CFSS) Individual | Limited* | ||
39 Physical Therapist | Moderate | X | |
40 Speech Language Pathologist | Limited | ||
42 Licensed Psychologist | Limited | ||
43 Audiologist | Limited | ||
44 Targeted Case Management | Limited | X | |
45 County Human Service Agency | Limited; | If CTSS or ARMHS | If CTSS or ARMHS |
46 Adult Day Treatment | Moderate* | X | X |
48 Rehabilitation Billing Entity | Limited | ||
49 Physician Billing Entity | Limited | ||
50 Intensive Residential Treatment Service (IRTS) | High* - Effective January 27, 2026 | X | X |
51 Indian Health Service | Limited; | If CTSS or ARMHS | X |
52 Federally Qualified Health Care Center | Limited | X | |
53 Rural Health Clinic | Limited | X | |
54 Family Planning Agency | Limited | ||
55 Community Health Worker | Limited | ||
56 Dental Lab | Limited | ||
57 Public Health Clinic | Limited | ||
58 Community Health Clinic | Limited | If CTSS or ARMHS | |
60 Home Health Agency | High for new enrollees; | X | X |
61 Public Health Nurse | Limited | X | |
62 Chemical Health | Limited | X | |
63 Licensed Psych Clinical Counselor | Limited | ||
64 Home Care Nurse | Limited* | ||
64 Home Care Nursing Agency | Moderate* | X | X |
65 Nurse Practitioner | Limited | ||
66 Nurse Midwife | Limited | ||
67 Cert Reg Nurse Anesthetist Group | Limited | ||
67 Cert Reg Nurse Anesthetist | Limited | ||
68 Clinic Nurse Specialist | Limited | ||
69 Physicians Assistant | Limited | ||
70 Pharmacy | Limited; | If DME | X |
70 Pharmacist | Limited | ||
72 Transportation Coordinator - Administrative Only | Limited | ||
73 WIC | Limited | ||
74 Head Start | Limited | ||
75 Optical Supplier | Limited | ||
76 Medical Supply | High for new enrollees; | X | X |
77 Hearing Aid Dispenser | Limited | ||
80 Independent Laboratory | Moderate | X | X |
81 Independent X-ray | Moderate | X | X |
82 Medical Transportation | Moderate for Ambulance; | X | X |
95 Clearing House - Administrative Only | Limited | ||
98 Billing Intermediary - Administrative Only | Limited | ||
AP Acupuncturist | Limited | ||
B1 Birthing Centers | Limited | X | |
C1 Certified Professional Midwife | Limited | ||
EI Early Intensive Developmental and Behavioral Intervention (EIDBI) – Agency | High* - Effective June 1, 2025. Submissions before June 1, 2025, are Moderate risk. | X | X |
EI EIDBI – Individual | Limited | ||
DC Licensed Alcohol and Drug Counselor | Limited | ||
RC Recovery Community Organization | High* - Effective January 27, 2026 | X | X |
DR Nonemergency Medical Transportation (NEMT) Drivers | Limited | ||
PR Psychiatric Residential Treatment Facilities (PRTF) | Limited | ||
HD Healthcare Delivery System - Administrative Only | Limited | ||
DA Doulas and Doula Organizations | Limited | ||
RE Recuperative Care | High*- Effective January 27, 2026 | X | X |
Effective January 27, 2026, all providers except Indian Health Service delivering the following services will be designated as high risk and subject to enhanced screening including a site visit.
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